This research aimed to establish whether resuscitating bleeding trauma victims using whole blood (WB) reduced their risk of death. Resuscitating trauma victims traditionally involves blood component therapy (BCT), with WB becoming the blood product of choice. Researchers expected that using WB instead of just BCT would reduce mortality. They compared the outcomes of resuscitating trauma patients with WB versus BCT at 14 different centers. They used a random-effects generalized linear mixed model, taking into account age, gender, injury etiology, and severity rating. Patients were included if they received blood during initial resuscitation. Secondary outcomes included acute renal injury, deep vein thrombosis/pulmonary embolism, pulmonary problems, and bleeding complications, with mortality as the primary outcome. The sample size was 1,623 (1,180 [74%] for WB and 443 [27%] for BCT), with 53% having suffered a penetrating injury and 47% having suffered a blunt injury. The patients who were given WB had a larger shock index (0.98 vs. 0.83), more comorbidities, and a greater blunt mechanism of injury (MOI) (all P<0.05). Acute renal injury, deep vein thrombosis/pulmonary embolism, and pulmonary consequences were not significantly different among centers, ages, sexes, MOI, or injury severity scores. When compared to patients who underwent BCT, those who underwent WB had a 48% lower risk of dying and a 94% lower risk of bleeding problems (P<0.0001). With WB, trauma patients had a 48% lower risk of dying from their injuries compared to those who received BCT. These findings lend credence to the administration of WB to trauma patients undergoing resuscitation.
